Managua Trip Report 2014

Bev and I began our 13th dental mission to Nicaragua, leaving Edmonton on Monday, January 6. This would be our 20th year of completing dental missions to developing countries. Our usual easy trip to Managua was punctuated with cancelled flights, re-routes and delayed baggage. We arrived in Managua late Tuesday evening, our baggage arriving late Wednesday evening. The flights had been delayed due to a major snowstorm on the eastern seaboard and the Midwest. Chicago airport had been closed for three days causing much havoc for the airline companies. The good news is that there is never any snow in Nicaragua.

We made our trip to collect our equipment and bring it to the village of Las Pilas on Thursday. It is about 4 hours northeast of Managua, located in the province of Chinandega. Our last visit to the village was 7 years ago. This is a rural community, with most the people working on small farms. The crops have been good the last few years, so people have had enough to eat and maybe even a little extra money for essentials. Salaries are very low, the High School Principal receives a little over 2000 Cordobas per month. That is less than $100/month. Most other people would be making less than half that salary.

When we arrived we discovered our venue had changed. We were supposed to work in the elementary school, but due to a change in the director, he cancelled permission to use the school. The clinic was set up in a play school and having worked there two times previously, we were familiar with the building. As we were supposed to also sleep at the school, a new facility had to be found. The school principal of the high school donated her home to us for our five-week stay at Las Pilas. We were very pleased with the home as it was a definite upgrade from the school.
When we discuss a home in the village, there needs to be some explanation. The home was a mixture of cement block and adobe brick. It is an open rafter building. It had a tiled, cement floor. The home had a fridge. There was a pila in the back where there was running water and that is where we washed, did our dishes, etc. A shower was provided, but there was only cold water available. The washroom was an outhouse and you had to watch out for fire ants on your trek to the facility. It had four bedrooms and a living room. One of the bedrooms was a place for fruit bats to eat their fruit at night, so we had to put up a plastic tarp to catch the dropping so they would not fall on us while we slept. It had its assortment of geckoes, roaches, beetles, scorpions, tailless whip scorpions, praying mantis and a hen roosting in the cupboard that eventually hatched three chicks.

We prepared the clinic and returned to Managua to await the arrival of our first team. The new team is brought to the clinic on Sunday where it is prepared for our first patients on Monday AM. Equipment is tested, the gas compressor is checked and started. I cannot get the gas generator to work. It is there strictly for back up but power can be an issue so we had to take it to a larger village on Monday to have it repaired.

We run our clinics from 8:00 AM to 5:00 PM. We prepare our own breakfast at the house. Lunch is brought to the clinic by the women who prepare our meals. We cannot work much past 5:00 PM as it begins to get dark and we only have one 100 watt light bulb for the area we are working. We have four dentists working at four stations and have a sterilizing station.
As in previous years, different villages are designated for a day at the clinic. The first week is usually allocated to the nearby villages but as time moves on, the further villages begin to appear. They will walk anywhere from 30 minutes to 3 hours to attend the clinic. We had a number of teenagers this year that had never been to a dentist in their life. Some had really good teeth, others were a disaster. One of the patients that we saw was a Down Syndrome boy of 18 years of age. He had 28 teeth and every one of the teeth were badly decayed. The front teeth were restored so that least when he smiled, they were white and not these big black decayed teeth.

Our 18-year-old Down Syndrome boy. Excellent patient

Our 18-year-old Down Syndrome boy. Excellent patient

We had another 10-year-old boy who was continually teased at school because he had a leg that was not formed properly he limped. His front permanent teeth were coming in crooked because of a lack of space. Because of this teasing, he had developed a response mechanism that he would throw up on demand. Then he would be sent to the principal’s office and he would not be teased anymore. We could not do anything about the leg, but we could remove some baby teeth to allow his permanent teeth to erupt into alignment. He was so appreciative of what we had done, he gave Dr. He a huge hug after everything was completed.

After the second work week, we return to Managua via the city of Granada. It is the oldest city in America. Team one leaves for Canada, Bev and I meet with the village of Nombre de Jesus where we will have our dental clinic in 2015. Team # 2 arrives on the Friday and we begin the process again.

The patients we see are arriving from further villages and subsequently, we have to do more extractions because the teeth are unrestorable. People walk for miles to see us. I drive an older lady home whom we extracted all of her remaining teeth. She lived 8 km from the clinic and had walked there in the morning.

We were fortunate in having a number of reading glasses donated to us by Heather Oullette, from Shopper’s Drug Mart. We had people walking as far for the glasses as they did for the dental treatment. Our interpreters became very adept at assisting people to choose the right glasses for their use. By the third week, we had given all the glasses away, well over 100 glasses.
We always have a story that touches our heart that we like to pass on. A female patient was in one of the dental chairs ready to get an exam and then treatment. She pointed out a tooth that was really bothering her. The interpreter asked how long the tooth had been a problem and she said seven years. Bev turned when she heard this and asked the interpreter to ask her again in case we had heard wrong. When questioned again, she said seven years. She had put up with this pain and discomfort for this long because she could not afford dental treatment. An extraction costs around 200 Cordoba’s which is $8.00. But when the average salary is $2.00 a day, and you have to provide for your family, you will sacrifice a lot of pain so that your family can eat.

UofA dental students, Don 3rd year and Jessica 4th year

Students for Las Pilas say goodbye to the dental team

Although we provide the dental services for the people, we are repaid by their generosity, gratitude and kindness. Being able to restore a smile, being able to alleviate the pain for someone who has been suffering for not just days but for years provides the team members much satisfaction. Sleeping in less than ideal conditions, working in less than ideal conditions, our team members gladly give of their time so that they can assist the people who really cannot afford dental care. And we have many of the team members who come year after year to provide this service.